This review was the last biennial review as currently mandated by US legislation.

New Vietnam veterans’ studies of United States women, Korean and New Zealand men were part of the review as were other epidemiological and toxicological studies.

Three conditions have a changed evidence category:

Addition of bladder cancer and hypothyroidism to the limited or suggestive evidence category

Removal of spina bifida in offspring from the limited or suggestive evidence category into the inadequate or insufficient evidence category

The removal of spina bifida occurred because the further evidence that was anticipated at the time of the first review in 1996 that would support the association between spina bifida and paternal exposure has not eventuated. This means that all birth defects are now in the inadequate or insufficient evidence category of an association with maternal or paternal exposure to dioxin and herbicides used in Vietnam.

The 2014 review committee concluded, as has previous reviews, that there is inadequate or insufficient evidence to determine whether there is an association between exposure of men and women to dioxin before conception or during pregnancy and disease in their children or grandchildren.